Suicidality and self‐injury with selective serotonin reuptake inhibitors in youth: Occurrence, predictors and timing
Objective Meta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non‐suicidal self‐injury (NSSI) associated with SSRI treatment in a cli...
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| Published in: | Acta psychiatrica Scandinavica Vol. 145; no. 2; pp. 209 - 222 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Blackwell Publishing Ltd
01.02.2022
John Wiley and Sons Inc |
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| ISSN: | 0001-690X, 1600-0447, 1600-0447 |
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| Abstract | Objective
Meta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non‐suicidal self‐injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents.
Methods
An observational, longitudinal, retrospective study using a within‐subject study design including in‐ and outpatients aged 0–17 years treated with SSRIs. Data were obtained from digital medical records and prescription software.
Results
N = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive‐compulsive disorder. No suicides occurred. When comparing the 6‐week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non‐significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non‐significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4–14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2–3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1–4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2–3.5], p = 0.01).
Conclusion
Suicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth. |
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| AbstractList | ObjectiveMeta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non‐suicidal self‐injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents.MethodsAn observational, longitudinal, retrospective study using a within‐subject study design including in‐ and outpatients aged 0–17 years treated with SSRIs. Data were obtained from digital medical records and prescription software.ResultsN = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive‐compulsive disorder. No suicides occurred. When comparing the 6‐week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non‐significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non‐significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4–14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2–3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1–4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2–3.5], p = 0.01).ConclusionSuicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth. Meta-analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non-suicidal self-injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents.OBJECTIVEMeta-analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non-suicidal self-injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents.An observational, longitudinal, retrospective study using a within-subject study design including in- and outpatients aged 0-17 years treated with SSRIs. Data were obtained from digital medical records and prescription software.METHODSAn observational, longitudinal, retrospective study using a within-subject study design including in- and outpatients aged 0-17 years treated with SSRIs. Data were obtained from digital medical records and prescription software.N = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive-compulsive disorder. No suicides occurred. When comparing the 6-week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non-significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non-significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4-14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2-3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1-4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2-3.5], p = 0.01).RESULTSN = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive-compulsive disorder. No suicides occurred. When comparing the 6-week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non-significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non-significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4-14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2-3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1-4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2-3.5], p = 0.01).Suicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth.CONCLUSIONSuicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth. Objective Meta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non‐suicidal self‐injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents. Methods An observational, longitudinal, retrospective study using a within‐subject study design including in‐ and outpatients aged 0–17 years treated with SSRIs. Data were obtained from digital medical records and prescription software. Results N = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive‐compulsive disorder. No suicides occurred. When comparing the 6‐week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non‐significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non‐significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4–14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2–3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1–4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2–3.5], p = 0.01). Conclusion Suicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth. Meta-analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study investigates the risk and possible predictors of suicidality and non-suicidal self-injury (NSSI) associated with SSRI treatment in a clinical sample of children and adolescents. An observational, longitudinal, retrospective study using a within-subject study design including in- and outpatients aged 0-17 years treated with SSRIs. Data were obtained from digital medical records and prescription software. N = 365 patients were included (64.1% female), mean (SD) age 14.5 (2.04) years, with primary depression, anxiety or obsessive-compulsive disorder. No suicides occurred. When comparing the 6-week period immediately prior to versus following SSRI initiation, the patient proportion with broadly defined suicidality decreased (38.5% vs. 24.2%, p < 0.001) while the proportion with suicide attempts was stable (2.8% vs. 2.8%, p = 1.000). The proportion with NSSI decreased statistically non-significantly (12.4% vs. 8.4%, p = 0.067). Results from individually standardized observation periods were similar; however, the proportion with suicide attempts decreased statistically non-significantly and the proportion with NSSI decreased significantly. Suicidality during SSRI treatment was associated with previous suicidality (OR[CI] = 6.0 [2.4-14.8], p < 0.001), depression as indication for SSRI treatment (OR[CI] = 2.1 [1.2-3.7], p = 0.01), female sex (OR[CI] = 2.1 [1.1-4.1], p = 0.02) and previous NSSI (OR[CI] = 2.0 [1.2-3.5], p = 0.01). Suicidality was common in youth treated with SSRIs. The patient proportion with overall suicidality decreased, and the proportion with attempted suicide was stable in the weeks following SSRI initiation. Previous suicidality, depression, female sex and previous NSSI are important predictors for suicidality during SSRI treatment in youth. |
| Author | Sørensen, Johanne Østerby Verhulst, Frank C. Rasmussen, Annette Roesbjerg, Troels Pagsberg, Anne Katrine |
| AuthorAffiliation | 1 Child and Adolescent Mental Health Center Mental Health Services Capital Region of Denmark Hellerup Denmark 2 Mental Health Services Capital Region of Denmark Copenhagen Ø Denmark 3 Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark |
| AuthorAffiliation_xml | – name: 1 Child and Adolescent Mental Health Center Mental Health Services Capital Region of Denmark Hellerup Denmark – name: 2 Mental Health Services Capital Region of Denmark Copenhagen Ø Denmark – name: 3 Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark |
| Author_xml | – sequence: 1 givenname: Johanne Østerby surname: Sørensen fullname: Sørensen, Johanne Østerby organization: Capital Region of Denmark – sequence: 2 givenname: Annette surname: Rasmussen fullname: Rasmussen, Annette organization: Capital Region of Denmark – sequence: 3 givenname: Troels surname: Roesbjerg fullname: Roesbjerg, Troels organization: Capital Region of Denmark – sequence: 4 givenname: Frank C. surname: Verhulst fullname: Verhulst, Frank C. organization: University of Copenhagen – sequence: 5 givenname: Anne Katrine surname: Pagsberg fullname: Pagsberg, Anne Katrine email: anne.katrine.pagsberg@regionh.dk organization: University of Copenhagen |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34374070$$D View this record in MEDLINE/PubMed |
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Meta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present... Meta-analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present study... ObjectiveMeta‐analyses have established a heightened risk of suicidality for youth treated with selective serotonin reuptake inhibitors (SSRIs). The present... |
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| SubjectTerms | Adolescent adolescents Antidepressants Child children Female Humans Male Medical records Mental depression non‐suicidal self‐injury Original Patients Retrospective Studies Self destructive behavior Self-Injurious Behavior - epidemiology serotonin reuptake inhibitors Serotonin uptake inhibitors Serotonin Uptake Inhibitors - adverse effects Suicidal Ideation suicidality Suicide Suicides & suicide attempts |
| Title | Suicidality and self‐injury with selective serotonin reuptake inhibitors in youth: Occurrence, predictors and timing |
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